Multiple sclerosis (MS) – Related resources

Cochrane reviews

• Interferon beta prevents the conversion from first event suggesting a demyelinating episode to clinically definite multiple sclerosis .
• Intravenous periodic high dose methylprednisolone appears to reduce long-term disability progression in relapsing-remitting multiple sclerosis .
• Despite some positive results in small trials, no reliable conclusion can be made on the efficacy of aminopyridines for symptoms of multiple sclerosis .
• Cyclophosphamide (CFX) may not prevent the risk of worsening in disabled patients with progressive multiple sclerosis (MS) in the long term, and major adverse effects are common .
• Hyperbaric oxygen therapy is probably not effective for the treatment of multiple sclerosis .
• There is insufficient evidence for the use of any treatment for ataxia or tremor in multiple sclerosis .
• Cognitive behavioural approaches may be beneficial in helping people to adjust to and cope with having MS and in the treatment of associated depression. Other psychological interventions may also be helpful .
• Multidisciplinary rehabilitation programmes do not change the level of impairment, but can improve the experience of people with MS in terms of activity and participation .
• There is no convincing evidence to support pharmacologic intervention as an effective treatment for memory disorder in multiple sclerosis .
• Statins appear not to be effective as an adjunctive therapy in multiple sclerosis .
• There appears to be no long-term benefit of intravenous corticosteroids for the recovery to normal visual acuity, visual field or contrast sensitivity in acute optic neuritis .
• Interferon beta does not appear to prevent the development of permanent physical disability in secondary progressive multiple sclerosis .
• Memory rehabilitation is probably not effective on memory function or functional abilities in multiple sclerosis .
• The effects of beta-interferons and glatiramer acetate are similar in relapsing-remitting multiple sclerosis regarding clinical and magnetic resonance imaging (MRI) parameters during two to three years. However, beta-interferons limit more effectively the increase in MRI lesion burden as compared with GA .

Other evidence summaries

• Complementary and alternative therapies may have limited effect on the physical symptoms and psychological well-being of MS patients . Interferon beta may produce important short-term gains in quality of life of patients with multiple sclerosis but the gains in QALYs are small .
• Magnetic resonance imaging may be of limited value in ruling in or ruling out early diagnosis of multiple sclerosis in patients with suspected disease .

Clinical guidelines

• Multiple sclerosis. National clinical guideline for diagnosis and management in primary and secondary care. National Institute for Health and Clinical Excellence (NICE)

Literature

• Compston A, Coles A. Multiple sclerosis. Lancet 2008 Oct 25;372(9648):1502-17.
• Ransohoff RM. Natalizumab for multiple sclerosis. N Engl J Med 2007 Jun 21;356(25):2622-9.